Correlation between clinical diagnosis based on RDC/TMD and MRI findings of TMJ internal derangement

The relationship between effusion of the temporomandibular joint (TMJ) and patient-reported disability is poorly researched. This pilot study explored the link between TMJ inflammation as measured by ultrasound and patient disability assessed by the Steigerwald Maher TMD Disability Index (SMTDI). The study design used a prospective correlational approach involving a sample with TMJ dysfunction (TMD). Twenty-four patients were recruited from the European School of Osteopathy and a Kent dental practice. Participants completed the SMTDI to determine the level of TMD (symptomatic score >20). A SonoSite SLA ''Hockey Stick'' [13-6 MHz] musculo-skeletal transducer was placed over the TMJ in a transverse direction and effusion was calculated indirectly by measuring capsular width. An upper left quadrant protocol was used throughout. A regression analysis was run with participants' gender, age and capsular width as predictor variables modelled against reported SMTDI. Larger capsular widths were found to be significant predictors of SMTDI scores (r ¼ 0.803, p < 0.0001). The patient profile matched with the previous studies and the TMD sufferer population, indicating external validity. Results suggest that the SMTDI could be integrated into practice life as a quick, accessible and easy tool to monitor patients' progress and assess levels of inflammation, without the need for repetitive imaging. The study design proved reproducible and a larger scale study is indicated.

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“…This is a similar result to the average sufferer age in previous studies of 25.3 AE 13.12 22 and 30.2-39. 4.…”

Section: Discussionsupporting

confidence: 91%

Temporomandibular joint effusion and its relationship with perceived disability assessed using musculoskeletal ultrasound and a patient-reported disability index

Bird

Bright

2015

Ultrasound

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“…For others, when a condyle is not symmetrically positioned due to torsion within the joint cavity, the evaluation in the conventional radiograph is only partially relevant 29 . MR imaging uses no radiation, has a high diagnostic accuracy, and is capable of assessing the disk position, disk shape, and bony changes; however, its cost is rather high 4,9,17,30 .…”

Section: Discussionmentioning

confidence: 99%

“…TMD diagnosis is based on the patient's medical history, in the clinical exam, and in the evaluation of the imaging exam [1][2][3]14,16 . The clinical diagnosis evaluates the mandibular movements and the pain associated with these movements, joint noises, and symptoms found upon palpation of the region of the joints and muscles associated with temporomandibular joint (TMJ) 17 . As regards the imaging exam, various radiographic techniques have been proposed to evaluate TMJ, such as the transcranial radiograph (TRANS), computed tomography (CT), cone beam computed tomography (CBCT), arthrography, and magnetic resonance (MR) 4,14,[17][18][19] .…”

Section: Introductionmentioning

confidence: 99%

Uso da radiografia transcraniana para detectar alterações morfológicas no côndilo mandibular

et al. 2017

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Purpose: to evaluate the accuracy of conventional transcranial radiographs (TRANS) to identify morphological changes in mandibular condyles. Methods: the sample consisted of 36 mandibular condyles, obtained from 18, randomly selected, dried human skulls, without the identification of age, gender, or ethnicity. Three experts in dental radiology examined the TRANS to identify possible changes in the condyles. The fourth examiner performed the macroscopic examination, which was considered the gold standard of the study. The condyles in both TRANS images and macroscopic examinations were classified as mandibular condyles with change (1) or no change (0). Statistical analyses were performed using the X 2 and the receiver operating characteristic (ROC) curve. Kappa intra-and interobserver tests were performed for examiners 1 to 3. Results: the X 2 test showed a statistically significant association between changes in the condyle in the TRANS images and the presence of macroscopic changes in the condyle (p < 0.05). The area under the curve was 0.83, with 96% sensitivity and 70% specificity. The weighted kappa value for intraobserver agreement was 0.78, while the interobserver agreement was 0.71. Conclusion: the use of TRANS proved to be an effective method to detect morphological changes in the mandibular condyle. Keywords: Temporomandibular Joint; / radiography; Temporomandibular Joint Disorders; Diagnostic Imaging RESUMOObjetivo: o objetivo deste estudo foi avaliar a acurácia das radiografias transcranianas (TRANS) convencionais na identificação das alterações morfológicas nos côndilos mandibulares. Métodos: a amostra consistiu em 36 côndilos mandibulares, obtidos a partir de 18 crânios secos humanos, aleatoriamente selecionados, sem identificação de idade, gênero ou etnia. Três especialistas em radiologia oral examinaram as TRANS para identificar possíveis alterações nos côndilos. Um quarto examinador realizou o exame macroscópico, que foi considerado o padrão ouro do estudo. As imagens das TRANS e os exames macroscópico foram classificados como (1) côndilos com alteração ou (0) côndilos sem alteração. A análise estatística foi realizada através do teste X 2 e da curva ROC (receiver operator characteristic). O teste Kappa intra e interexaminadores foi realizado para os examinadores 1 a 3. Resultados: o teste X 2 mostrou uma associação estatisticamente significativa entre as alterações no côn-dilo vistas nas imagens TRANS e a presença de alterações macroscópicas (p < 0,05). A área sob a curva ROC foi de 0,83, com 96% de sensibilidade e 70% de especificidade. O valor Kappa para a concordância intraobservador foi de 0,78, enquanto que a concordância interexaminador foi de 0,71. Conclusão: o uso de radiografias transcranianas apresentou-se como método eficaz para a detecção de alterações morfológicas no côndilo mandibular.

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“…Wikes stages are determined by the placement and morphology of the articular disc and the bone destruction of hip process shown in TMJ MRI 7) . TMJ MRI is the gold standard in the diagnosis of TMJ [8][9][10] . The anabolism and formation of the bone were caused by the hpofunction of ovary and the decline of estrogen as for the postmenopausal women.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Characteristic Indeices Related to Temporomandibular Joint Osteoarthrosis

Zhou

Ueno

et al. 2013

J. Hard Tissue Biology.

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The purpose of this study was to investigate the relationship between the bone mineral density and the contents of osteocalcin calcium and phosphorus in serum with temporomandibular joint osteoarthrosis (TMJOA). The mineral densities of lumbar and neck of femur research groups, including the case group and the control group, were compared. The contents of osteocalcin calcium and phosphorus in serum were also measured and evaluated. The results showed that the mean bone mineral density of the case group (TMJOA group) was lower than that of the control group (healthy control). However, a statistical difference was not reflected. The mineral density of the neck of femur of the case group is lower than that of the controlled group obviously, suggesting that mineral density of the femur was related with TMJOA. It was presumed that the bone mineral density of the femur neck might have relationship with TMJOA. The level of osteocalcin in serum of the case group was significantly lower than that of the control group. Thus it is presumed that osteocalcin had a relationship with TMJOA. The results showed that the capability of bone transformation and formation in TMJOA were all decreased. No relationship was found between calcium phosphorus in serum and TMJOA.

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Correlation between clinical diagnosis based on RDC/TMD and MRI findings of TMJ internal derangement

Cited by 75 publications

References 20 publications

Temporomandibular joint effusion and its relationship with perceived disability assessed using musculoskeletal ultrasound and a patient-reported disability index

Temporomandibular joint effusion and its relationship with perceived disability assessed using musculoskeletal ultrasound and a patient-reported disability index

Uso da radiografia transcraniana para detectar alterações morfológicas no côndilo mandibular

Investigation of Characteristic Indeices Related to Temporomandibular Joint Osteoarthrosis

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